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Evaluation and Management (E/M) services account for 30% of the revenue paid by Medicare for all physician services. For many specialties, E/M codes account for 60-70% of total revenue. Maximum reimbursement depends on understanding to rules regulated to these services. This session outlines the rules related to major categories of E/M service. About the Speaker This course is hosted by Betsy Nicoletti, co-founder of Codapedia.com, a wiki devoted to physician reimbursement. As a certified coder, Betsy simplifies complex coding rules for practitioners and engages physicians in a positive and respectful way, which encourages attention and accuracy in their coding. Besides doing auditing and compliance work, she is a speaker, writer and consultant in coding education, billing and accounts receivable management.   CEU 2 AAPC CEUs (can be earned through September 30, 2019) Important Notes Recorded August 3, 2016. Availity cannot issue refunds. This program has the prior approval of AAPC for up to two continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.   Special Purchasing/Volume Discounts Like this course? This is course two of a five-part series: The Confident Coder Series with Betsy Nicoletti. To learn about the other courses in the series, click here. Read More

Physician services are paid based on CPT and HCPCS codes, when medical necessity is supported by the ICD-10 code. Simple, until you factor in rules related to place of service, modifiers, NCCI edits, global payments, and coverage determinations. This is an essential primer for new staff and providers. About the Speaker This course is hosted by Betsy Nicoletti, co-founder of Codapedia.com, a wiki devoted to physician reimbursement. As a certified coder, Betsy simplifies complex coding rules for practitioners and engages physicians in a positive and respectful way, which encourages attention and accuracy in their coding. Besides doing auditing and compliance work, she is a speaker, writer and consultant in coding education, billing and accounts receivable management. CEU 2 AAPC CEUs (can be earned through September 30, 2019) Important Notes Recorded August 1, 2016. Availity cannot issue refunds. This program has the prior approval of AAPC for up to two continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. Special Purchasing/Volume Discounts Like this course? This is course one of a five-part series: The Confident Coder Series with Betsy Nicoletti. To learn about the other courses in the series, click here. Read More

Practitioners, administrators, billing and coding staff will love these five webinar-style courses. Coding drives revenue, compensation and compliance. It requires more than the ability to look up a single code: the provider or coder needs to understand the rules behind the codes. This series is a great review course for experienced practitioners and staff and is an essential learning guide for new practitioners and staff members. All specialty medical practices can benefit. Click the course titles to view individual descriptions -  $49 each. Save over $45 when you purchase the bundle. Each one of these courses brings accurate, up-to-date coding knowledge and answers the most commonly asked, tricky questions: 1. HOW PHYSICIAN SERVICES ARE PAID - $49 This course explains how coding and reimbursement work together. Getting this right means getting paid on the first submission. Getting this wrong means payment delays and denials. Use this for your next in-service training. 2. RULES FOR EVALUATION AND MANAGEMENT (E/M) SERVICES - $49 For most specialties, Evaluation and Management (E/M) services make up a large part of annual revenue, accounting for 60-70% of total revenue. It is critical to understand the CPT rules related to these services and to report the correct category of code. This webinar provides in-depth understanding of billing E/M services. 3. DIAGNOSIS CODING: THE ROUTE FROM MEDICAL NECESSITY TO RISK-BASED ADJUSTMENT - $49 In many practices, diagnosis coding is the step-child of coding, getting attention only when a claim is denied for medical necessity. In a fee-for-service world, worrying about medical necessity is the first priority of diagnosis coding. As practices join Accountable Care Organizations and comply with MACRA, understanding risk adjusted diagnosis coding is important. This webinar discusses both medical necessity and risk adjusted diagnosis coding. 4. DENIALS YOU COULD HAVE PREVENTED - $49 All medical practices want to avoid denials. Denials delay payment. Some services that are denied are never resubmitted and the group receives no money for the service performed. Researching and resubmitting denials is a labor-intensive task. The smart move is to reduce denials by using software edits prior to submission. A second, brilliant move is to understand the reasons for denials you could have prevented and improve work flow to reduce denials. 5. MEDICARE AND NON-PHYSICIAN PRACTITIONER BILLING - $49 Advance practice nurses (APRNs) and physician assistants (PAs) provide valuable services in primary care, medical specialties and surgical specialties.  Medicare has specific rules about billing for these professionals, however, and doing it wrong is a compliance risk and a lost revenue opportunity.  Any practice that includes PAs and APRNs needs to review the Medicare rules. This webinar allows you to do that. Important Note: Availity cannot issue refunds. Read More

If you have mid-level, non-physician practitioners (NPPs) in your office, you can't afford to miss this webinar! Medicare billing rules for nurse practitioners, physician assistants, clinical nurse specialists, and other NPPs can be confusing and are often misunderstood. The result? Inaccurate coding and possible overpayment. Medicare has been concerned about inaccurate NPP billing and has ramped up their audits for NPP billing. In this webinar Teri Romano will simplify these complicated billing rules and also discuss how private payers and Medicare billing for mid-levels differs. In this webinar, you’ll learn What your options are for billing your non-physician practitioners services to Medicare The difference between direct, incident-to, and split/shared billing in the office setting and the reimbursement impact of each When an NPP office visit can be billed under the physician’s name and number and when must it be billed under the NPPs name and number How to determine how your private payers reimburse for NPPs   About the Speaker Teresa Romano has over twenty-five years of consulting and teaching experience in the health care field. Ms. Romano works with physician groups and hospitals combining a background in clinical systems with solid approaches to operational and organizational problem solving. Ms. Romano is co-developer and instructor for the national coding and reimbursement workshops sponsored by the Society for Vascular Surgery and the American Association of Neurologic Surgeons. She also provides on-site customized coding and reimbursement courses to physician and hospital groups, specializing in vascular surgery, vein and neurosurgery as well as E & M and surgical case audits to assist physician groups in their compliance activities. In addition, she consults with vein, vascular and neurosurgical practices on practice management issues including revenue enhancement, appeals management and expense reduction. CEU 1 AAPC CEU (can be earned through May 31, 2019)   Important Notes Recorded May 21, 2013. Availity cannot issue refunds. This program has the prior approval of AAPC for one continuing education hour. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. Read More

In this session, Sarah Holt, national speaker and expert on healthcare management topics, will dive into the complicated world of health insurance. The complexity of health insurance in the United States is unquestionable. Only those who understand health insurance can maximize productivity when working in healthcare. This session will identify the purpose of healthcare insurance, create a framework for you to help clarify the major types of health insurance, identify the role of each type of insurance, and break down each type of insurance into its various components so that the complexity of health insurance is less daunting. You'll learn The difference between three major types of health insurance—government, commercial for-profit, and non-governmental not-for-profit The components of generating a claim and the steps included in filing a claim The elements of health insurance and how each works—premium, copayment, deductible, insurance payment, and coinsurance The components of commercial insurance along the managed care spectrum—FFS, DFFS, HMO, PPO, and POS The scope of government health insurance How Medicare and Medicaid funding differ The difference between Medicare Parts A, B, C, and D Which providers are paid by each part of Medicare The various Medicaid eligibility groups About the Speaker Sarah is a full-time faculty member at Southeast Missouri State University, Cape Girardeau, MO, in the new bachelor’s and master’s health management programs. The program has been ranked among the nation’s top 10 Best Online Healthcare Administration Degrees. For many years she has been a successful medical practice executive and consultant for health care organizations. Her teaching experience includes teaching graduate level university classes; health care administration in the MHA program at Saint Louis University. She has facilitated on-line classes for MGMA and speaks nationally on health care management topics to audiences of physicians, management, and staff. Sarah is the author of two books published by Medical Group Management Association. Get the Money in the Door: Physician Billing Basics, 2010, a primer for training medical office insurance staff and is instructional for medical practice executives to know what their billing staff needs to know to be effective. Medical Office Billing: A Self-Study Training Manual, 2013, a comprehensive introduction to and basic understanding of the fundamentals of medical office insurance. Important Notes Webinar recorded May 3, 2012. Availity cannot issue refunds Read More

Who is the first point of contact when your patient enters your office? When looking to hire your front-desk staff you want a friendly customer centered person, but you also want know that they can perform the essential tasks that provide information for clean claims. This 40-question assessment developed for medical practices by Sarah Holt, of Holt Medical Practice Solutions, can be your best chance at screening qualified front desk staff that are more than a friendly face. About the Speaker Sarah is a full-time faculty member at Southeast Missouri State University, Cape Girardeau, MO, in the new bachelor’s and master’s health management programs. The program has been ranked among the nation’s top 10 Best Online Healthcare Administration Degrees. For many years she has been a successful medical practice executive and consultant for health care organizations. Her teaching experience includes teaching graduate level university classes; health care administration in the MHA program at Saint Louis University. She has facilitated on-line classes for MGMA and speaks nationally on health care management topics to audiences of physicians, management, and staff. Sarah is the author of two books published by Medical Group Management Association. Get the Money in the Door: Physician Billing Basics, 2010, a primer for training medical office insurance staff and is instructional for medical practice executives to know what their billing staff needs to know to be effective. Medical Office Billing: A Self-Study Training Manual, 2013, a comprehensive introduction to and basic understanding of the fundamentals of medical office insurance. Important Notes Recorded March 10, 2016. Availity cannot issue refunds for assessments. In accordance with this Agreement, Availity hereby grants the licensee a limited, non-exclusive, non-transferable, perpetual license to use the Online Assessment or Online Assessments for licensee's internal business purposes only. DISCOUNT ALERT: Purchase all four assessments for $175. Read More

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